Hearing health and dementia
Authors: Pádraig T Kitterick, Brent E Edwards
Journal: The Lancet Public Health (2023)

Fan Jiang and colleagues1Jiang F Mishra SR Shrestha N et al.Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohort.Lancet Public Health. 2023; 8: e329-e338Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar recently examined the association between hearing aid use and all-cause and cause-specific dementia in The Lancet Public Health.1Jiang F Mishra SR Shrestha N et al.Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohort.Lancet Public Health. 2023; 8: e329-e338Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar The authors observed that hearing aid use in those who self-report hearing problems appears to modify the risk of dementia. They concluded that the management of hearing loss should be treated as an urgent public health concern to improve health outcomes in later life. When discussing these important insights, both the original Article1Jiang F Mishra SR Shrestha N et al.Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohort.Lancet Public Health. 2023; 8: e329-e338Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar and the accompanying Comment2Livingston G Costafreda S Preventing dementia through correcting hearing: huge progress but more to do.Lancet Public Health. 2023; 396: e319-e320Summary Full Text Full Text PDF Scopus (2) Google Scholar conflate the presence of self-reported hearing difficulties with the presence of a hearing loss. There is an important distinction between these two concepts in the field of hearing health care, which is supported by the fact that self-reported hearing problems have been found to arise consistently in the absence of a clinically-defined hearing loss, and vice versa.3Humes LE US population data on hearing loss, trouble hearing, and hearing-device use in adults: National Health and Nutrition Examination Survey, 2011–12, 2015–16, and 2017–20.Trends Hear. 2023; 27 (23312165231160978)Google Scholar There is also consistency in the findings of studies examining the association between self-reported hearing problems and dementia, with the current study almost exactly replicating the pattern of results obtained from a previous cohort study.4Amieva H Ouvrard C Meillon C Rullier L Dartigues JF Death, depression, disability, and dementia associated with self-reported hearing problems: a 25-year study.J Gerontol A Biol Sci Med Sci. 2018; 73: 1383-1389Crossref PubMed Scopus (80) Google Scholar In fact, on the rare occasion where the associations between self-reported hearing difficulties, hearing loss, and dementia are compared, the evidence suggests that the stronger association exists between perceived hearing problems and dementia than between hearing loss and dementia.5Marinelli JP Lohse CM Fussell WL et al.Association between hearing loss and development of dementia using formal behavioural audiometric testing within the Mayo Clinic Study of Aging (MCSA): a prospective population-based study.Lancet Healthy Longev. 2022; 3: e817-e824Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar When trying to understand the bases of associations between hearing health and dementia, recognition of the distinction between the perception of hearing problems and the presence of an audiometrically-defined hearing loss is important, and to consider these as distinct risk factors that might be indicative of different underlying pathologies. We declare no competing interests. Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohortIn people with hearing loss, hearing aid use is associated with a risk of dementia of a similar level to that of people without hearing loss. With the postulation that up to 8% of dementia cases could be prevented with proper hearing loss management, our findings highlight the urgent need to take measures to address hearing loss to improve cognitive decline. Full-Text PDF Open AccessHearing health and dementiaWhether hearing aids delay dementia is a pressing public health question.1 In The Lancet Public Health, Fan Jiang and colleagues2 recently reported that untreated hearing loss is associated with all-cause dementia risk (HR 1·42), with no increased risk among hearing aid users. In their Comment, Gill Livingston and Sergi Costafreda3 raise important considerations for the interpretation of these findings, including that hearing aid users could have greater economic, social, or cognitive resources than non-users. Full-Text PDF Open AccessHearing health and dementia – Authors' replyIn their Correspondence, Jennifer Deal and Nicholas Reed propose that when estimating the effect of hearing aid use on dementia risk, individuals with hearing loss not using hearing aids should be an alternative reference group. Such grouping based on hearing loss might allow counterfactual assessment of the effect of hearing loss on dementia risk depending on the use (and not use) of hearing aids. In our Article,1 a reference group of people without hearing loss was compared with those with hearing loss who did or did not use hearing aids. Full-Text PDF Open Access